El código postal como “código de barras” de las resistencias antimicrobianas / The postal code as a “bar code” of antimicrobial resistance

Introducción. La necesidad de integrar en la práctica clínica las resistencias locales es cada vez más urgente, especialmente en Atención Primaria, donde el tratamiento empírico es frecuente. Material y métodos. Se desarrolló un estudio retrospectivo observacional en el área de salud de Alcalá de Henares de los aislados microbiológicos positivos de Neisseria gonorrhoeae de cualquier localización (uretral, cervical, faríngea, rectal u orina). Se analizaron características sociodemográficas y resistencias a cefalosporinas, azitromicina, penicilina y quinolonas. Se relacionó cada aislado con su código postal de procedencia. Resultados. Se analizaron 256 muestras microbiológicas de N. gonorrhoeae, la mayoría pertenecientes a hombres (92,9%) con edad media de 33 años. La mitad de las muestras (49,8%) fueron resistentes a ciprofloxacino. La evolución temporo-espacial de las resistencias antimicrobianas se integró en mapas de calor con los códigos postales con más resistencias. Conclusión. Conocer las resistencias locales puede ayudar a pautar tratamientos empíricos más adecuados, especialmente en Atención Primaria, evitando la utilización de antibióticos inadecuados y disminuyendo las tasas de resistencias. (AU)

Introduction. The need to integrate local resistances into clinical practice is increasingly urgent, especially in Primary Care where empirical treatment is frequent. Methods. A retrospective observational study of positive microbiological isolates of Neisseria gonorrhoeae from any location (urethral, cervical, pharyngeal, rectal or urine) was carried out in the health area of Alcalá de Henares. Sociodemographic characteristics and resistance to cephalosporins, azithromycin, penicillin and quinolones were analyzed. Each isolate was related to its postal code of origin. Results. We analyzed 256 microbiological samples of N.gonorrhoeae, most of them male (92.9%) with a mean age of 33 years. Half of the samples (49.8%) were resistant to ciprofloxacin. Temporal and spatial evolution of antimicrobial resistance was integrated in heat maps. Conclusion. Knowing local resistances can help to prescribe more adequate empirical treatments, especially in Primary Care, avoiding inadequate antibiotics and decreasing resistance rates. (AU)

Monkeypox outbreak predominantly affecting men who have sex with men, Madrid, Spain, 26 April to 16 June 2022.

Up to 22 June 2022, 508 confirmed cases of monkeypox (MPX) have been reported in the Madrid region of Spain, 99% are men (n = 503) with a median age of 35 years (range: 18-67). In this ongoing outbreak, 427 cases (84.1%) reported condomless sex or sex with multiple partners within the 21 days before onset of symptoms, who were predominantly men who have sex with men (MSM) (n = 397; 93%). Both the location of the rash, mainly in the anogenital and perineal area, as well as the presence of inguinal lymphadenopathy suggest that close physical contact during sexual activity played a key role in transmission. Several cases reported being at a sauna in the city of Madrid (n = 34) or a mass event held on the Spanish island of Gran Canaria (n = 27), activities which may represent a conducive environment for MPX virus spread, with many private parties also playing an important role. Because of the rapid implementation of MPX surveillance in Madrid, one of the largest outbreaks reported outside Africa was identified. To minimise transmission, we continue to actively work with LGBTIQ+ groups and associations, with the aim of raising awareness among people at risk and encouraging them to adopt preventive measures.

[Tuberculosis trend in Madrid region in native and foreign population (2009-2018).] / Tendencia de la tuberculosis en la Comunidad de Madrid en población autóctona y extranjera (2009-2018).

OBJECTIVE: Tuberculosis is a major public health problem and most cases are concentrated in vulnerable populations. The objective was to describe the incidence rates trend in native and foreign population (2009-2018) in Madrid Region. METHODS: Retrospective analysis of cases from the Tuberculosis Regional Registry of cases of Madrid Region 2009-2018. Annual incidence rates were calculated by country of birth (Spain, other), sex and age group (<15, 15-34, 35-44, 45-64, >64), using the annual January 1st continuous register population. The infection rate trend and the annual percentage change (APC) were calculated, along with the best jointpoint adjustment using Jointpoint regression. RESULTS: 7,696 cases were analyzed, 48.2% were foreign-born individuals. Average age in native population was 50 years old (SD: 23.96) and 35 (DS: 36.64) in foreign-born individuals (p<0.001). The overall incidence rate decreased from 17.30 in 2009 to 9.00 per 100,000 in 2018 and was higher in men. Pulmonary tuberculosis reduced from 11.90 to 6.55. Among native population, the incidence of TB fell from 10.29 to 5.24 with an APC of -7.3% (95%IC: -8.9; -5.7) (p<0.05), no jointpoint was identified. Among foreign-born individuals the incidence of tuberculosis declined from 46.54 to 25.49, a joint point was identified in 2013, observing an incidence decrease for the period 2009-2013 and APC of -13.8% (IC95%: -17.5; -10.0). CONCLUSIONS: The global incidence rate in this period has decreased by approximately 7% per year. However, this reduction occurred mainly in native population. In foreign-born individuals the incidence decreased by approximately 14% during the 2009-2013 period, after this period there have been no significant incidence changes.

OBJETIVO: La tuberculosis (TB) continúa siendo un problema importante de salud pública, debido a que la mayoría de los casos se concentran en población vulnerable. El objetivo de este trabajo fue describir la tendencia de las tasas de incidencia en población autóctona y extranjera (2009-2018) en la Comunidad de Madrid (CM). METODOS: Se realizó un análisis retrospectivo de casos del Registro Regional de casos de Tuberculosis de la CM en el período 2009-2018. Se calcularon tasas de incidencia anual por cada 100.000 habitantes, por país de nacimiento (España, fuera de España), sexo y grupo de edad (<15, 15-34, 35-44, 45-64, >64), utilizando las poblaciones de padrón continuo a 1 de enero de cada año. Se calculó la tendencia de las tasas de incidencia y el porcentaje anual de cambio (APC), así como el mejor ajuste del punto de inflexión utilizando la regresión de Jointpoint. RESULTADOS: Se analizaron 7.696 casos, siendo el 48,2% en personas nacidas fuera de España. La edad media en población autóctona fue de 50 años (DS: 23,96) y 35 (DS: 36,64) en inmigrante (p<0,001). La tasa de incidencia global pasó de 17,30 por cada 100.000 habitantes en 2009 a 9 en 2018, siendo superior en hombres. La incidencia de tuberculosis pulmonar pasó de 11,90 a 6,55. En población autóctona, la incidencia de TB pasó de 10,29 a 5,24, con un APC de -7,3% (IC95%: -8,9; -5,7; p<0,05), y no se identificó ningún punto de inflexión. En población extranjera la incidencia de tuberculosis pasó de 46,54 a 25,49, identificándose un punto de inflexión en 2013, con una disminución más acusada de la incidencia para el periodo 2009-2013 debido a un APC de -13,8% (IC95%: -17,5; -10,0). CONCLUSIONES: La tasa de incidencia global en este periodo disminuye cerca de un 7% anual; sin embargo, esta disminución de la incidencia se produce fundamentalmente en población autóctona. En población extranjera la incidencia desciende cerca de un 14% durante el periodo 2009-2013. Tras este periodo no hay cambios significativos en la incidencia.

Tendencia de la tuberculosis en la Comunidad de Madrid en población autóctona y extranjera (2009-2018) / Tuberculosis trend in Madrid region in native and foreign population (2009-2018)

OBJETIVO: La tuberculosis (TB) continúa siendo un problema importante de salud pública, debido a que la mayoría de los casos se concentran en población vulnerable. El objetivo de este trabajo fue describir la tendencia de las tasas de incidencia en población autóctona y extranjera (2009-2018) en la Comunidad de Madrid (CM). MÉTODOS: Se realizó un análisis retrospectivo de casos del Registro Regional de casos de Tuberculosis de la CM en el período 2009-2018. Se calcularon tasas de incidencia anual por cada 100.000 habitantes, por país de nacimiento (España, fuera de España), sexo y grupo de edad (<15, 15-34, 35-44, 45-64, >64), utilizando las poblaciones de padrón continuo a 1 de enero de cada año. Se calculó la tendencia de las tasas de incidencia y el porcentaje anual de cambio (APC), así como el mejor ajuste del punto de inflexión utilizando la regresión de Jointpoint. RESULTADOS: Se analizaron 7.696 casos, siendo el 48,2% en personas nacidas fuera de España. La edad media en población autóctona fue de 50 años (DS: 23,96) y 35 (DS: 36,64) en inmigrante (p < 0,001). La tasa de incidencia global pasó de 17,30 por cada 100.000 habitantes en 2009 a 9 en 2018, siendo superior en hombres. La incidencia de tuberculosis pulmonar pasó de 11,90 a 6,55. En población autóctona, la incidencia de TB pasó de 10,29 a 5,24, con un APC de -7,3% (IC95%: -8,9; -5,7; p < 0,05), y no se identificó ningún punto de inflexión. En población extranjera la incidencia de tuberculosis pasó de 46,54 a 25,49, identificándose un punto de inflexión en 2013, con una disminución más acusada de la incidencia para el periodo 2009-2013 debido a un APC de -13,8% (IC95%: -17,5; -10,0). CONCLUSIONES: La tasa de incidencia global en este periodo disminuye cerca de un 7% anual; sin embargo, esta disminución de la incidencia se produce fundamentalmente en población autóctona. En población extranjera la incidencia desciende cerca de un 14% durante el periodo 2009-2013. Tras este periodo no hay cambios significativos en la incidencia

OBJECTIVE: Tuberculosis is a major public health problem and most cases are concentrated in vulnerable populations. The objective was to describe the incidence rates trend in native and foreign population (2009-2018) in Madrid Region. METHODS: Retrospective analysis of cases from the Tuberculosis Regional Registry of cases of Madrid Region 2009-2018. Annual incidence rates were calculated by country of birth (Spain, other), sex and age group (<15, 15-34, 35-44, 45-64, >64), using the annual January 1st continuous register population. The infection rate trend and the annual percentage change (APC) were calculated, along with the best jointpoint adjustment using Jointpoint regression. RESULTS: 7,696 cases were analyzed, 48.2% were foreign-born individuals. Average age in native population was 50 years old (SD: 23.96) and 35 (DS: 36.64) in foreign-born individuals (p < 0.001). The overall incidence rate decreased from 17.30 in 2009 to 9.00 per 100,000 in 2018 and was higher in men. Pulmonary tuberculosis reduced from 11.90 to 6.55. Among native population, the incidence of TB fell from 10.29 to 5.24 with an APC of -7.3% (95%IC: -8.9; -5.7) (p < 0.05), no jointpoint was identified. Among foreign-born individuals the incidence of tuberculosis declined from 46.54 to 25.49, a joint point was identified in 2013, observing an incidence decrease for the period 2009-2013 and APC of -13.8% (IC95%: -17.5; -10.0). CONCLUSIONS: The global incidence rate in this period has decreased by approximately 7% per year. However, this reduction occurred mainly in native population. In foreign-born individuals the incidence decreased by approximately 14% during the 2009-2013 period, after this period there have been no significant incidence changes

Balanopostitis severa secundaria al tratamiento con imiquimod tópico / Severe balanoposthitis secondary to treatment with topical imiquimod

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Effects on varietal aromas during wine making: a review of the impact of varietal aromas on the flavor of wine.

Although there are many chemical compounds present in wines, only a few of these compounds contribute to the sensory perception of wine flavor. This review focuses on the knowledge regarding varietal aroma compounds, which are among the compounds that are the greatest contributors to the overall aroma. These aroma compounds are found in grapes in the form of nonodorant precursors that, due to the metabolic activity of yeasts during fermentation, are transformed to aromas that are of great relevance in the sensory perception of wines. Due to the multiple interactions of varietal aromas with other types of aromas and other nonodorant components of the complex wine matrix, knowledge regarding the varietal aroma composition alone cannot adequately explain the contribution of these compounds to the overall wine flavor. These interactions and the associated effects on aroma volatility are currently being investigated. This review also provides an overview of recent developments in analytical techniques for varietal aroma identification, including methods used to identify the precursor compounds of varietal aromas, which are the greatest contributors to the overall aroma after the aforementioned yeast-mediated odor release.

Necrosis cutánea de pene tras corporoplastia de Nesbit / Cutaneous penile necrosis after Nesbit corporoplasty

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Bladder cancer with Indian ink. / Cáncer vesical con pigmento de tinta china.

72 year old female with a historyof breast cancer in remission, under study formonosymptomatic haematuria. Cystoscopy studyshows pigmented mucosal areas...

Paciente mujer de 72 años con antecedentede cáncer de mama en remisión, enestudio en urología por hematuria macroscópicamonosintomática. Se realiza cistoscopia observandoáreas de mucosa pigmentada...

Mixed alcoholic fermentation of Schizosaccharomyces pombe and Lachancea thermotolerans and its influence on mannose-containing polysaccharides wine Composition.

This study researched the winemaking performance of new biotechnology involving the cooperation of Lachancea and Schizosaccharomyces genera in the production of wine. In all fermentations where Lachancea thermotolerans was involved, higher lactic acid concentrations appeared, while all fermentations where Schizosaccharomyces pombe was involved, lower levels in malic acid concentration took place. The sensorial properties of the final wines varied accordingly. Differences in mouthfeel properties and acidity occurred in the different fermentation trials. Fermentations with the highest concentration of hydrolyzed mannose showed the highest mouthfeel properties, but the lack of acidity reduced their overall impression. Wines made from a combination of L. thermotolerans and S. pombe showed the highest overall impression and were preferred by the tasters due to the balance between mouthfeel properties and acidity.

Cáncer vesical con pigmento de tinta china / No disponible

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Erosión externa, complicación del esfínter urinario artificial / External erosion. Artificial urinary sphincter complication

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Schizosaccharomyces pombe Biotechnological Applications in Winemaking.

The traditional way of producing wine is through the use of Saccharomyces cerevisiae in order to convert glucose and fructose into alcohol. In the case of red wines, after this alcoholic fermentation lactic bacteria Oenococus oeni is used to stabilize wine from a microbiological point of view by converting malic acid into lactic acid that it is not a microbiological substract. The yeast species Schizosaccharomyces pombe was traditionally considered spoilage yeast. Nevertheless, during the last decade it started to be used due to its unique malic acid deacidification ability to reduce the harsh acidity of wines from northern Europe, by converting malic acid to ethanol and CO2 without producing lactic acid as lactic bacteria does. Additionally, during the last years, S. pombe has started to be used to solve the problems of modern winemaking industry such as increasing food quality or food safety. Some of those new uses, different from its traditional malic acid deacidification, are: high autolytic polysaccharides release, gluconic acid reduction, urease activity that make impossible ethyl carbamate (toxic compound) formation, high pyruvic acid production, that is related to color improvement, and removing lactic bacteria subtracts while avoiding biogenic amines (toxic compounds such as histamine) formation.

Schizosaccharomyces pombe Isolation Protocol.

This chapter describes a methodology to isolate yeast strains from Schizosaccharomyces pombe species. The method is based on a selective-differential medium that notably facilitates the isolation of S. pombe. The main difficulty in isolating microorganisms from this genus is their extremely low incidence in nature when they are compared to other microorganisms. The proposed methodology allows isolating and selecting strains from this species for industrial purposes. Methodologies allows detecting the presence of those yeasts when they are considered spoilage microorganisms. Several selective-differential agents based on the basic physiological characteristics of S. pombe species are exposed during the chapter introduction and the use is properly justified. Some of those representative characteristics are its extraordinary resistance to high sugar concentrations, sulfur dioxide, sorbic acid, benzoic acid, acetic acid, or their unique malo-ethanolic fermentation ability. The proposed selective medium is mainly based on S. pombe resistance to the antibiotic actidione and the unusual tolerance to the inhibitory agent benzoic acid compared to possible microorganisms that could produce false-positive results during an isolation process. In addition, malic acid is proposed as the main differential factor due to the exclusive ability of this species to metabolize malic acid into ethanol. This fact allows the detection of malic acid degradation. Cloramphenicol is used to inhibit bacteria growth and liquid media to avoid fungi development.

Tumor de Ackerman del pene / Ackerman's tumor of the penis

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